scholarly journals Evaluation of effectiveness Postisometric Muscle Relaxation and Classical Massage in the Treatment of Neck Pain Syndromes

2019 ◽  
Vol 61 (1) ◽  
pp. 17-23
Author(s):  
Mariusz Wojciuk ◽  
Anna Kuryliszyn-Moskal ◽  
Katarzyna Kaniewska

Introduction: Ailments located in the cervical spine are a serious clinical problem. The aim of the study was to evaluate the effectiveness of Postisometric Relaxation (PIR) and Classical Massage (CM) in analgesic therapy in patients with neck chronic increased muscle tension. Material and methods: The study was carried out in a group of 36 adults (mean age 49.5±8.59 years, 29 women) with neck increased muscle tension due to overload changes. Patients were randomly assigned into two groups. The therapy consisted of 10 PIR or CM procedures. VAS (Visual Analogue Scale), NDI (Neck Disability Index), SF-MPQ (McGill Pain Questionnaire-Short Form by Melzack) were used. The trigger points were assessed and the mobility of the cervical spine was measured. Results: A statistically significant reduction in pain was obtained in both groups (improvement in the PIR group: 70%±29, CM 55%±27). In the PIR group, trigger points were completely eliminated in 50% of subjects and in the CM group in 38.9%. There was a statistically significant reduction in the NDI in both groups (improvement in the PIR group 70%±26, CM 48%±29). In both groups, a statistically significant increase in the mobility of the cervical spine in all directions was observed (extension, lateral flexion and rotation were statistically significantly better in the PIR group). Conclusions: PIR and CM statistically significantly reduce pain, improve health, effectively eliminate trigger points and increase the mobility of the cervical spine. PIR better increases the range of extension, lateral flexion and rotation of the cervical spine.

2010 ◽  
Author(s):  
Βικτωρία Μισαηλίδου

Σκοπός της παρούσας ερευνητικής μελέτης ήταν να διερευνηθεί η επίδραση τριών προγραμμάτων θεραπευτικής άσκησης στην αίσθηση πόνου, στη λειτουργική ικανότητα, στην αποφυγή λόγω φόβου, στην ποιότητα ζωής, στο εύρος κίνησης της αυχενικής μοίρας της Σ.Σ., στην αντοχή των καμπτήρων και εκτεινόντων μυών της αυχενικής μοίρας της Σ.Σ. και στην αναπνευστική λειτουργία σε ασθενείς με χρόνιο αυχενικό πόνο. Στην έρευνα έλαβαν μέρος 60 ασθενείς με χρόνιο αυχενικό πόνο οι οποίοι χωρίστηκαν σε τρεις ομάδες των 20 ατόμων. Στην πρώτη ομάδα έγινε αξιολόγηση και εφαρμόστηκε θεραπεία σύμφωνα με τις αρχές της μεθόδου McKenzie, στη δεύτερη ομάδα έγινε αξιολόγηση και εφαρμόστηκε θεραπεία με ένα εξελικτικό πρόγραμμα ασκήσεων διάτασης, ενδυνάμωσης, αντοχής και ιδιοδεκτικότητας και στην τρίτη ομάδα έγινε εφαρμογή αναπνευστικών ασκήσεων και τεχνικών χαλάρωσης. Όλοι οι συμμετέχοντες έλαβαν 12 συνεδρίες σε διάστημα 4-6 εβδομάδων ενώ οι μετρήσεις πραγματοποιήθηκαν πριν από την έναρξη και μετά την ολοκλήρωση της θεραπευτικής παρέμβασης. Για την αξιολόγηση της αίσθησης πόνου χρησιμοποιήθηκε το ερωτηματολόγιο McGill Pain Questionnaire – short form (SF-MPQ), της λειτουργικής ικανότητας το Neck Disability Index (NDI), της αποφυγής λόγω φόβου το Fear Avoidance Beliefs Questionnaire (FABQ) και για την ποιότητα ζωής το SF-36 Health Survey. Το εύρος κίνησης μετρήθηκε με ειδικό γωνιόμετρο κεφαλής Cervical Range of Motion Instrument(CROM), η αντοχή των καμπτήρων και εκτεινόντων μυών με χρονόμετρο χειρός και η αναπνευστική λειτουργία με φορητό σπιρόμετρο. Σύμφωνα με τα αποτελέσματα διαπιστώθηκε στατιστικά σημαντική βελτίωση στην αίσθηση πόνου, στη λειτουργική ικανότητα, στην αποφυγή λόγω φόβου, στην ποιότητα ζωής, στο εύρος κίνησης της αυχενικής μοίρας της Σ.Σ., στην αντοχή των καμπτήρων και εκτεινόντων μυών της αυχενικής μοίρας της Σ.Σ. και στην αναπνευστική λειτουργία μετά την εφαρμογή των θεραπευτικών προγραμμάτων και στις τρεις πειραματικές ομάδες με διαφοροποιήσεις στα ποσοστά βελτίωσης της κάθε ομάδας. Η ομάδα McKenzie, παρουσίασε τη μεγαλύτερη βελτίωση στον πόνο, στη λειτουργική ικανότητα , στην έκταση της αυχενικής μοίρας και στην αντοχή των καμπτήρων και εκτεινόντων μυών του αυχένα. Η ομάδα ενδυνάμωσης παρουσίασε τη μεγαλύτερη βελτίωση στην αποφυγή λόγω φόβου, στην ποιότητα ζωής, και στην κάμψη και στροφές της αυχενικής μοίρας ενώ η ομάδα των αναπνευστικών ασκήσεων παρουσίασε τη μεγαλύτερη βελτίωση στην αναπνευστική λειτουργία. Όλα τα θεραπευτικά προγράμματα είχαν θετικά αποτελέσματα αλλά κάποια κλινικά χαρακτηριστικά των ασθενών φαίνεται ότι ανταποκρίνονται καλύτερα σε συγκεκριμένους τύπους θεραπείας. Προτείνεται έρευνα που να ταξινομεί τους ασθενείς με χρόνιο αυχενικό πόνο σε υποομάδες με κοινά κλινικά χαρακτηριστικά με σκοπό να διερευνηθεί αν η ταξινόμηση αυτή βοηθάει στην βελτίωση του θεραπευτικού αποτελέσματος.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zahra Rezasoltani ◽  
Hanna Ehyaie ◽  
Reza Kazempour Mofrad ◽  
Fatemeh Vashaei ◽  
Reza Mohtasham ◽  
...  

Abstract Objectives Granisetron and lidocaine injections have been used for the management of myofascial pain syndrome. This study was aimed to compare the efficacy of granisetron and lidocaine injections to trigger points of upper trapezius in the management of myofascial pain syndrome. Methods We performed a double-blind randomized clinical trial in an outpatient clinic of physical medicine and rehabilitation at a teaching hospital. A total of 40 patients aged ≥18 with neck pain due to myofascial pain syndrome were included. They had pain for at least one month with the intensity of at least 30 mm on a 100 mm visual analog scale. Each participant received a single dose of 1 mL lidocaine 2% or 1 mg (in 1 mL) granisetron. The solutions were injected into a maximum of three trigger points of the upper trapezius. We instructed all patients to remain active while avoiding strenuous activity for three or four days, and to perform stretch exercise and massage of their upper trapezius muscles. We assessed the patients before the interventions, and one month and three months post-injection. The primary outcome was the Neck Disability Index and the secondary outcome was the Neck Pain and Disability Scale. Results Both interventions were successful in reducing neck pain and disability (all p-values <0.001). However, the neck pain and disability responded more favorably to lidocaine than granisetron (p=0.001 for Neck Disability Index, and p=0.006 for Neck Pain and Disability Scale). No significant side-effect was recognized for both groups. Conclusions Both lidocaine and granisetron injections to trigger points are effective and safe for the management of the syndrome and the benefits remain at least for three months. However, lidocaine is more effective in reducing pain and disability. The injections are well-tolerated, although a transient pain at the site of injections is a common complaint. One mL of lidocaine 2% is more effective than 1 mg (in 1 mL) granisetron for injecting into the trigger points of the upper trapezius in myofascial pain syndrome.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 463.2-464
Author(s):  
A. Alawamy ◽  
M. Hassanien ◽  
E. Talaat ◽  
E. Kamel

Background:Rheumatoid arthritis is a common type of autoimmune arthritis characterized by chronic inflammation. Cervical spine is often affected specially in long lasting diseaseObjectives:Evaluate efficacy of Third occipital nerve Radiofrequency under fluoroscopic guidance to treat refractory cervicogenic headache in RA patients.Methods:The current study was revised and approved from the local ethical committee of Faculty of Medicine; Assiut University, then registered in the clinical trials under the number ofNCT03852355. Inclusion criteria included, Patients who fulfilled the American College of Rheumatology (ACR) (2010) criteria for RA and suffering from upper neck pain and/or headache due to bilateral 3rd occipital nerve involvement, excluding other local cervical spine pathologies was confirmed by MRI and previously failed conservative treatment for at least three months prior to enrollment. Sixty adult patients were randomly assigned to one of the two studied groups Group 1 (RF, n = 30), received bilateral Third occipital nerve Radiofrequency under fluoroscopic guidance or Group 2 (control group, n = 30), received oral prednisolone 10 mg/day. The two groups were then followed-up with neck disability index (NDI), nocturnal neck pain VAS score and headache score every two weeks for three months. Sleep disturbance, sleep disability index were reassessed six months post intervention. Post interventional assessment was done by pain physician who were kept blind to the grouping process.Results:Neck disability index (1ry outcome), Nocturnal pain VAS, and severity of headache showed significant differences during the whole post-interventional study period. The patients in RF group demonstrated significant improvement of pain in comparison to baseline value over the whole six months with p-value < 0.001 as regard to the fore-mentioned three parameters. On the other aspect, the control group patients showed significant improvement in comparison to its baseline value after the 2nd, 12th and 24th weeks only as follows: (0.001,0.003, 0.003 for the NDI) (p values of 0.02,0.01, 0.01 for the nocturnal pain VAS), (0.001 0.009, 0.005 for the headache VAS severity.Conclusion:Radiofrequency of 3rd occipital nerve is effective in treatment of refractory cervicogenic headache in RA.Disclosure of Interests: :None declared


2018 ◽  
Vol 8 (7) ◽  
pp. 703-708 ◽  
Author(s):  
Andreas Kiilerich Andresen ◽  
Rune Tendal Paulsen ◽  
Frederik Busch ◽  
Alexander Isenberg-Jørgensen ◽  
Leah Y. Carreon ◽  
...  

Study Design: Retrospective cohort study. Objectives: It is estimated that 10 000 patients seek medical care due to cervical radiculopathy every year in Denmark. Although the natural course is usually favorable, around 20% undergo surgery for cervical degenerative disease every year in Denmark. We aim to evaluate the patient-reported results and satisfaction of anterior cervical decompression and fusion over a 5-year period from a single Danish center for spine surgery. Methods: This study is a retrospective study based on prospectively collected data from 318 consecutive patients treated with anterior cervical decompression and fusion over 1 to 3 levels. Data in the DaneSpine registry was collected pre- and postoperatively, and at 1 year after surgery. The outcome measures were Neck Disability Index (NDI), European Quality of Life 5D (EQ-5D), visual analogue score (VAS), and Short Form-36 Physical Component Summary (SF-36 PCS). Results: Of 318 cases enrolled, 272 (85.5%) had follow-up data available at a minimum 1-year postoperatively. The mean preoperative NDI was 40.0 and improved to 22.7. Mean EQ-5D was 0.50 and improved to 0.70, and mean VAS arm was 60.4 improved to 26.4. All improvements were statistically significant. A total of 74.3% were back to work 1 year after surgery. Achieving minimal clinically important difference (MCID) in VAS neck and SF-36 PCS was strongly correlated to patient satisfaction. Conclusion: Patients who undergo anterior cervical discectomy and fusion can expect improvement in their pain and disability, with 74.3% of patients reporting a positive change in health status after surgery.


2014 ◽  
Vol 21 (3) ◽  
pp. 394-399 ◽  
Author(s):  
Leah Y. Carreon ◽  
Kelly R. Bratcher ◽  
Nandita Das ◽  
Jacob B. Nienhuis ◽  
Steven D. Glassman

Object The Neck Disability Index (NDI) and numeric rating scales (0 to 10) for neck pain and arm pain are widely used cervical spine disease–specific measures. Recent studies have shown that there is a strong relationship between the SF-6D and the NDI such that using a simple linear regression allows for the estimation of an SF-6D value from the NDI alone. Due to ease of administration and scoring, the EQ-5D is increasingly being used as a measure of utility in the clinical setting. The purpose of this study is to determine if the EQ-5D values can be estimated from commonly available cervical spine disease–specific health-related quality of life measures, much like the SF-6D. Methods The EQ-5D, NDI, neck pain score, and arm pain score were prospectively collected in 3732 patients who presented to the authors' clinic with degenerative cervical spine disorders. Correlation coefficients for paired observations from multiple time points between the NDI, neck pain and arm pain scores, and EQ-5D were determined. Regression models were built to estimate the EQ-5D values from the NDI, neck pain, and arm pain scores. Results The mean age of the 3732 patients was 53.3 ± 12.2 years, and 43% were male. Correlations between the EQ-5D and the NDI, neck pain score, and arm pain score were statistically significant (p < 0.0001), with correlation coefficients of −0.77, −0.62, and −0.50, respectively. The regression equation 0.98947 + (−0.00705 × NDI) + (−0.00875 × arm pain score) + (−0.00877 × neck pain score) to predict EQ-5D had an R-square of 0.62 and a root mean square error (RMSE) of 0.146. The model using NDI alone had an R-square of 0.59 and a RMSE of 0.150. The model using the individual NDI items had an R-square of 0.46 and an RMSE of 0.172. The correlation coefficient between the observed and estimated EQ-5D scores was 0.79. There was no statistically significant difference between the actual EQ-5D score (0.603 ± 0.235) and the estimated EQ-5D score (0.603 ± 0.185) using the NDI, neck pain score, and arm pain score regression model. However, rounding off the coefficients to fewer than 5 decimal places produced less accurate results. Conclusions The regression model estimating the EQ-5D from the NDI, neck pain score, and arm pain score accounted for 60% of the variability of the EQ-5D with a relatively large RMSE. This regression model may not be sufficient to accurately or reliably estimate actual EQ-5D values.


Author(s):  
Kotteeswaran. K ◽  
Chiranjibi Kumar Nayak

Background: Cervical spine dysfunction is a cause of neck pain. The cause for it is believed to be a disorder (most likely malalignment) of the pain-sensitive facet joints (which may also be due to disc disruption). Dysfunction can also cause secondary muscle spasm, which can may lead to more pain and stiffness. Objective: To find the effectiveness of SNAGs and scapular strengthening exercises in the patients with chronic cervical dysfunction. To find the Neck disability index (NDI) score difference between the functional activities of experimental group and conventional treatment group. Methodology: According to inclusion and exclusion criteria a prior to the study, the principal researcher explained the procedures to all the subjects and inform consent obtained, 30 subjects taken through Random block design and numbering was done for all the subjects. All the odd numbers in one group and all the even numbers in another group are allocated by random table where each group had 15 subjects. The collected data was tabulated and analyzed using descriptive and inferential statistics. To all parameters mean and standard deviation (SD) were used. Paired t-test was used to analyze significant changes between pre-test and post-test measurements. Unpaired t-test was used to analyze significant changes between two groups. Result: rom statistical analysis made with the quantitative data revealed statistically significant difference between the Group A and Group B, and also within the group. The Posttest mean value of Neck Disability Index (NDI) in group A is 12.00 and in group B is 13.80. This shows that Neck Disability Index (NDI) in Group B disability value were comparatively more than Group A disability value, P<0.0001. Conclusion: This study shows better improvement in reducing cervical spine dysfunction (neck pain) by scapular strengthening exercise than resisted neck isometrics. Both the techniques can be used in clinical practice.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yunxuan Huang ◽  
Jiabi Zhang ◽  
Buhui Xiong ◽  
Ruina Huang ◽  
Wenjing Zhao ◽  
...  

Abstract Background Thunder-fire moxibustion originated in China and contains traditional Chinese medicine. It can produce strong firepower, infrared thermal radiation, and medicinal effects when burning on the acupoints. Thunder-fire moxibustion is commonly used in patients with neck pain, but its efficacy has rarely been systematically demonstrated. We designed a randomized trial of thunder-fire moxibustion on cervical spondylotic radiculopathy (CSR) to investigate whether it is more effective than ibuprofen sustained-release capsules. Methods One hundred patients will be recruited and randomly divided into thunder-fire moxibustion and ibuprofen groups. The intervention consists of ten treatments and will last for 2 weeks. The Yasuhisa Tanaka 20 Score Scale is used as the primary outcome measure. It contains a combination of the self-conscious symptom in patients, objective clinical evaluation from doctors, and social evaluation (the ability to work and live). The objective and comprehensive evaluation of CSR patients before and after treatment is particularly needed. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Neck Disability Index score scale (NDI), and the Quality of Life Assessment (SF-36) are applied as secondary outcome measures. The assessment will take place at the baseline and the first and second weekends of treatment. If an adverse event (AEs) occurs, it will be reported. Discussion The aim of this trial is to determine whether thunder-fire moxibustion is more effective than ibuprofen in the treatment of patients with CSR. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR1800018820. Registered on 11 October 2018.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pavlos Bobos ◽  
Evdokia Billis ◽  
Dimitra-Tania Papanikolaou ◽  
Constantinos Koutsojannis ◽  
Joy C. MacDermid

Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM) was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67) completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05). However, no differences were found within and between the therapeutic groups (p<0.05) in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.


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